To understand whether the disorder was due to a hypothalamic deficiency (GnRH deficiency) or pituitary disease (doubtful microadenoma of 3 mm), we performed a TRH test, given the finding of low fT4, and an GnRH analogue test, even if these tests are not suggested in the diagnostic workup for amenorrhea (35). This evidence concerns the gene GNRH1 and pituitary gland disorder.